MAAUA: 2007 Abstracts - Kidney Cancer and Competing Causes of Mortality: An Age-based Population Study

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Kidney Cancer and Competing Causes of Mortality: An Age-based Population Study
David A Kunkle*, Brian L Egleston*, Robert G Uzzo
Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA

Introduction: The rising incidence of renal cell carcinoma (RCC) due to incidental detection of small renal masses (SRM) has been associated with a stage migration. Unfortunately this has not resulted in a significant improvement in cancer-specific or overall survival for patients with RCC. Recent data regarding active surveillance of the SRM has demonstrated a low incidence of progression to M+ disease. We analyzed competing causes of mortality as a function of patient age in a population-based study.
Methods: Results from the National Vital Statistics Reports were used to determine survival rates and mortality in the United States. Patients were stratified into 5 age categories. Death rates were classified as related to non-cancer mortality, non-RCC cancer mortality, or RCC related mortality.
Results: Five-year mortality data for 2,448,288 US deaths (in 2003) were compiled and analyzed for cause of death (Table). Nearly 25% of patients over 75 and 55% of patients over 85 will die of other causes within 5 years while the overall risk of death from RCC represented a very small percentage in this cohort.
Conclusions: Mortality from RCC represents a small fraction of all causes of death in the United States. Five-year mortality from competing causes increases with increasing patient age. These data suggest that active surveillance of renal tumors may be appropriate for selected elderly and comorbid patients.
Five-year causes of mortality in the United States.
Age Group 5-year Mortality from Kidney Cancer, (%) 5-year Mortality from Other Cancers, (%) 5-year Mortality from Non-Cancer Causes, (%) 5-year All-cause Overall Survival (%)
45-54 years 0.01 0.6 1.5 97.9
55-64 years 0.04 1.6 2.9 95.4
65-74 years 0.08 3.6 7.1 89.2
75-84 years 0.12 5.7 18.7 75.5
85 years and over 0.12 6.2 48.2 45.4

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